Medicare starts at age 65 for most people
You become may be able to access for Medicare the month you turn 65, regardless of whether you are still working. The program is federal health insurance run by the Centers for Medicare & Medicaid Services (CMS), and it covers hospital care, doctor visits, and prescription drugs through different parts you choose when you enroll.
You do not have to wait until your birthday month ends—coverage can begin on the first day of the month in which you turn 65. If you were born on any day in a given month, your coverage starts on the first of that month. This matters because you have a window to sign up, and missing it can delay your coverage or cost you more later.
Key Takeaways
- Medicare enrollment begins three months before you turn 65 and ends three months after, giving you a seven-month window to sign up without penalties.
- If you miss your initial enrollment window, you may pay a permanent penalty on your monthly premiums, even if you sign up years later.
- Some people under 65 may be may be able to access for Medicare if they receive Social Security Disability Insurance (SSDI) for 24 months or have end-stage renal disease or ALS.
- You can enroll online at Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office.
The enrollment window: when to sign up
Your Initial Enrollment Period (IEP) runs for seven months: three months before you turn 65, the month you turn 65, and three months after. During this time, you can sign up for Medicare Part A (hospital insurance) and Part B (medical insurance) without waiting or paying extra.
If you do not sign up during this window, you enter what Medicare calls the General Enrollment Period, which runs January 1 through March 31 each year. Coverage would not start until July 1 of that year—a significant delay. More importantly, you will owe a late enrollment penalty: a permanent 10 percent increase to your Part B premium for each full 12-month period you were may be able to access but did not enroll. This penalty stays with you for life, even after you finally sign up.
The same penalty applies to Part D (prescription drug coverage) if you go without it for 63 days or more in a row and later enroll. The penalty is 1 percent of the national base premium for each month you were without coverage.
Who can get Medicare before 65
You may be may be able to access for Medicare before age 65 if you have received Social Security Disability Insurance (SSDI) for 24 consecutive months. The 24-month clock starts the month your disability benefits begin, not the month you applied. Once you reach that mark, Medicare begins automatically—you do not need to explore again.
You are also may be able to access before 65 if you have been diagnosed with end-stage renal disease (ESRD)—permanent kidney failure requiring dialysis or a transplant. Coverage can start the month dialysis treatment begins or the month you receive a kidney transplant, whichever comes first. Similarly, if you have amyotrophic lateral sclerosis (ALS), also called Lou Gehrig's disease, you become may be able to access for Medicare when ready upon diagnosis, with no waiting period.
If any of these situations explore to you, contact Social Security at 1-800-772-1213 to confirm your may be able to access and enrollment status. Social Security handles these cases directly.
Medicare parts and what they cover
Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health services. Most people do not pay a monthly premium for Part A if they or their spouse paid Medicare taxes while working for at least 10 years (40 quarters). If you do not meet this requirement, you can still buy Part A, but the premium varies based on how many quarters of coverage you have.
Part B covers doctor visits, outpatient care, medical equipment, and preventive services. It has a monthly premium that changes each year—in 2024 it was $164.90 for most people, though higher earners pay more. You also pay a yearly deductible before Part B coverage begins, and then a 20 percent coinsurance on most services.
Part D covers prescription drugs through private insurance companies that contract with Medicare. You choose a plan during your enrollment window, and premiums and coverage vary by plan. Part C, also called Medicare Advantage, is an alternative to Parts A and B offered by private insurers. It usually includes drug coverage and may offer dental or vision benefits, but it has different rules about which doctors you can see.
How to enroll in Medicare
You can enroll online at Medicare.gov, the official government website. The enrollment tool walks you through your options and lets you compare plans side by side. You will need your Social Security number and information about your current health coverage, if you have any.
You can also call 1-800-MEDICARE (1-800-633-4227) to speak with a representative who can answer questions and help you enroll over the phone. The line is available 24 hours a day, seven days a week. If you prefer in-person help, visit your local Social Security office—staff there can help you sign up for Medicare at the same time you handle other Social Security business.
If you are still working at 65 and have health coverage through your employer, you may be able to delay Part B enrollment without penalty under a rule called creditable coverage. You will still need to enroll in Part A, but Part B can wait as long as your employer coverage continues. When you do enroll in Part B later, you have eight months from the time your employer coverage ends to sign up without penalty. Ask your employer's benefits department whether your plan qualifies.
What happens if you miss the important date
If you do not enroll during your Initial Enrollment Period and you do not have creditable coverage through an employer, you will face a late enrollment penalty on Part B that lasts for life. The only way to avoid this penalty is to enroll during the General Enrollment Period (January 1 through March 31) and accept the delay until July 1 coverage begins.
You can request a penalty waiver if you can show that Medicare or Social Security gave you incorrect information that caused you to miss the important date. The request must be made in writing to your local Social Security office, and approval is not may provide. It is far easier to enroll on time than to fight a penalty later.
Frequently Asked Questions
Do I have to enroll in Medicare at 65 if I am still working?
You must enroll in Part A at 65, but you may be able to delay Part B if you have health coverage through your current employer and that coverage is considered creditable. Contact your employer's benefits department to confirm. If you delay Part B, you have eight months after your coverage ends to enroll without penalty.
What if I turn 65 and do not have health insurance?
Enroll in Medicare when ready during your Initial Enrollment Period. Part A has no monthly premium for most people, and Part B coverage begins the month you turn 65 if you enroll on time. Waiting past your enrollment window will cost you more in penalties and leave you uninsured in the meantime.
Can I change my Medicare plan after I enroll?
Yes, during the Annual Enrollment Period (October 15 through December 7 each year), you can switch between Original Medicare and Medicare Advantage, or change your Part D drug plan. Changes take effect January 1. Outside this window, you can only change plans if you have a may have access to life event, such as moving out of your plan's service area.
Will Medicare cover everything once I turn 65?
Medicare covers a wide range of services, but it does not cover everything. Dental, vision, and hearing care are generally not covered under Original Medicare, though some Medicare Advantage plans include these benefits. You may want to buy a supplemental policy (Medigap) to cover costs Medicare does not pay.
What if I am not a U.S. citizen?
You must be a U.S. citizen or permanent resident who has lived in the United States for at least five consecutive years to be may be able to access for Medicare. Permanent residents should have a green card and Social Security number. Contact Social Security to confirm your may be able to access status.